Multidetector computed tomography for preoperative identification of left gastric vein location in patients with gastric cancer

Abstract

Background. The area near the left gastric vein (LGV) is a challenging site at which to perform dissection of the lymph nodes during gastrectomy. Therefore, knowledge of the precise location of the LGV is important. The objective of this study was to examine the usefulness of multidetector computed tomography (MDCT) for the identifi cation of the LGV. Methods. Eighty-one patients with gastric cancer underwent MDCT, which was performed with contrast media in 76 patients and without contrast media in 5 patients. A 5-mm thin slice of the frontal image was reconstructed. These images were examined preoperatively to detect the location of the LGV. Upon gastrectomy, the LGV was identifi ed and its location compared to that determined by MDCT. Results. The LGV was identifi ed by MDCT in 76 of the 81 patients (93.8%). The LGV was subsequently located during the operation in all 81 patients. The LGV was located dorsal to the common hepatic artery in 40 patients (49.4%), ventral to the common hepatic artery in 18 patients (22.2%), ventral to the splenic artery in 17 patients (21.0%), dorsal to the splenic artery in 2 patients (2.5%) and in other positions in 4 patients (4.9%). In all patients, the location of the LGV detected using MDCT was consistent with that identifi ed during gastrectomy. In the 4 patients with relatively unusual locations of the LGV, these 4 LGV variants were identifi ed preoperatively by MDCT. Conclusion. MDCT was useful for identifying the location of the LGV prior to gastrectomy.

Left gastric vein on the dorsal side of the splenic artery: a rare anatomic variant revealed during gastric surgery

“…Preoperative familiarity with the anatomical features of the LGV is therefore required to avoid accidental dissection of the LGV. Analysis of abdominal CT results of 81 patients showed that the LGV locations could be detected by MDCT preoperatively in 76 patients (93.8 %) [11]. Similarly, we found that LGV locations could be detected by CT reconstruction.…”

Three-dimensional computed tomography analysis of the left gastric vein in a pancreatectomy

“…Computed tomography (CT) analysis of the LGV's path has already been performed as part of the laparoscopic treatment of gastric cancer, 2 to locate the vein before surgery and reduce the bleeding that could result from dissection along the common hepatic artery (CHA) during a gastrectomy for cancer 3,4 . However, we are not aware of similar studies concerning the pre‐operative analysis of the LGV before a pancreatectomy.…”

Preoperative assessment of perigastric vascular anatomy by multidetector computed tomography angiogram for laparoscopy-assisted gastrectomy

“…The recent development of multidetector computed tomography (MDCT) makes it possible to perform threedimensional CT angiography (3D CTA) imaging, which appears to be an effective and reliable technique for recognizing the perigastric vascular anatomy [6][7][8][9][10][11][12][13]. However, this technique requires at least two scanning phases.…”